Individual
NICHOLAS ANTHONY NOVOTNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1766 HORICON ST, MAYVILLE, WI 53050-1256
(920) 387-2640
Mailing address
211 MERTON AVE, HARTLAND, WI 53029-1812
(262) 313-8753
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001276
WI
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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